What is the Difference Between Ketoacidosis and Lactic Acidosis

The key difference between ketoacidosis and lactic acidosis is that ketoacidosis is a type of metabolic acidosis occurring due to the build-up of ketones in the bloodstream, while lactic acidosis is a type of metabolic acidosis occurring due to the build-up of lactic acid in the bloodstream.

Metabolic acidosis normally develops when too much acid is produced in the human body. It can also occur when the kidney cannot remove enough acid from the body. There are several types of metabolic acidosis, including diabetic ketoacidosis, hyperchloremic acidosis, kidney disease, lactic acidosis, poisoning by aspirin, ethylene glycol, or methanol, and severe dehydration.

CONTENTS

1. Overview and Key Difference
2. What is Ketoacidosis 
3. What is Lactic Acidosis
4. Similarities – Ketoacidosis vs Lactic Acidosis
5. Metabolic Acidosis vs Metabolic Alkalosis in Tabular Form
6. Summary – Metabolic Acidosis vs Metabolic Alkalosis

What is Ketoacidosis?

Ketoacidosis is a type of metabolic acidosis that is due to the build-up of ketones in the bloodstream. Ketoacidosis is associated with high serum levels of ketone bodies. There are several clinically important ketoacidosis, including diabetic ketoacidosis, alcoholic ketoacidosis, and starvation ketoacidosis. Diabetic ketoacidosis is due to hyperglycemia and insulin insufficiency, which causes the lipolysis and oxidation of free fatty acids. Alcoholic ketoacidosis occurs due to alcohol abuse, liver disease, and acute alcohol ingestion. Starvation ketoacidosis occurs after the body is deprived of glucose as the primary source of energy for a long time and fatty acids replace glucose as the major metabolic fuel.

The symptoms of diabetic ketoacidosis include fast deep breathing, dry skin and mouth, flushed face, fruity smelling breath, headache, muscle stiffness or aches, being very tired, nausea, and vomiting. Symptoms of alcoholic ketoacidosis include nausea, vomiting, abdominal pain, agitation, confusion, changes of level alertness, deep, laboured breathing, loss of appetite, dehydration, dizziness, and thirst. Moreover, the symptoms of starvation ketoacidosis include lower muscle mass, lower body temperature, minimal body fat, low pulse rate, obvious bony prominences, tooth decay, thin hair, and low blood pressure.

Ketoacidosis can be diagnosed through blood tests, urinalysis, chest X-ray, and electrocardiogram. Furthermore, treatments for diabetic ketoacidosis include fluid replacement, electrolyte replacement, and insulin therapy, while treatments for alcoholic ketoacidosis include intravenous thiamine, intravenous dextrose, replacement of potassium, phosphorous, and magnesium, medicines for alcohol withdrawal, and medicines to help nausea. Meanwhile, treatments for starvation ketoacidosis include intravenous glucose.

What is Lactic Acidosis?

Lactic acidosis is a type of metabolic acidosis that occurs due to the build-up of lactic acid in the bloodstream. Lactic acidosis is caused by intense exercise, some medical conditions (cancer, seizures, liver failure, vitamin B deficiency, sepsis, and shock), and some drugs (metformin for diabetes and acetaminophen). The symptoms of lactic acidosis are burning feelings in muscles, cramps, nausea, weakness, feeling exhausted, fruity-smelling breath, jaundice, trouble breathing, abdominal pain, diarrhoea, headache, and rapid heart rate.

Lactic acidosis is usually diagnosed through a fasting blood test. Furthermore, treatments for lactic acidosis include increasing oxygen in the tissues and giving intravenous fluid. Lactic acidosis can be prevented by taking proper medication for diabetes, HIV, cancer, and avoiding misuse of alcohol.

What are the Similarities Between Ketoacidosis and Lactic Acidosis?

• Ketoacidosis and lactic acidosis are two types of metabolic acidosis.
• In both conditions, the level of acids in the bloodstream increases.
• Both conditions can lead to life-threatening complications.
• They can be diagnosed through blood tests.
• They can be treated by giving intravenous fluid and replacing electrolytes.

What is the Difference Between Ketoacidosis and Lactic Acidosis?

Ketoacidosis is a type of metabolic acidosis due to the build-up of ketones in the bloodstream, while lactic acidosis is a type of metabolic acidosis due to the build-up of lactic acid in the bloodstream. Thus, this is the key difference between ketoacidosis and lactic acidosis. Furthermore, there are three types of ketoacidosis are diabetic ketoacidosis, alcoholic ketoacidosis, and starvation ketoacidosis, and two types of lactic acidosis as type A lactic acidosis and type B lactic acidosis.

The below infographic presents the differences between ketoacidosis and lactic acidosis in tabular form for side-by-side comparison.

Summary – Ketoacidosis vs Lactic Acidosis

Metabolic acidosis normally occurs when too much acid is produced in the human body or when the kidney cannot remove enough acids from the body. Ketoacidosis and lactic acidosis are two different types of metabolic acidosis. Ketoacidosis occurs when ketones build up in the bloodstream while lactic acidosis occurs when lactic acids build up in the bloodstream. So, this is the key difference between ketoacidosis and lactic acidosis.

Reference:

1. “Ketoacidosis.” – StatPearls – NCBI Bookshelf.
2. Whelan, Corey. “Lactic Acidosis: Symptoms, Causes, Treatment & More.” Healthline, Healthline Media.

Image Courtesy:

1. “Diabetic Ketoacidosis” By Gblanchard16 – Own work (CC BY-SA 4.0) via Commons Wikimedia
2. “Lactic Acid Fermentation” By Lisawerner9 – Own work (CC BY-SA 4.0) via Commons Wikimedia